Provider Demographics
NPI:1336518299
Name:HORNBERGER, DAWN R (CRNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:R
Last Name:HORNBERGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17846-5020
Mailing Address - Country:US
Mailing Address - Phone:570-484-9230
Mailing Address - Fax:717-949-4140
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:PA
Practice Address - Zip Code:17846-5020
Practice Address - Country:US
Practice Address - Phone:570-484-9230
Practice Address - Fax:717-949-4140
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015206363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care